Abstract
<p style="margin-bottom: 0in;"><span style="color: #231f20;"><span style="font-family: Helvetica-Narrow,sans-serif;"><span style="font-size: x-small;">A 40 year old multiparous asymptomatic woman presented at 9+ weeks with a finding of rising serum beta-HCG over 3500 IU without ultrasonically detectable intra-uterine pregnancy. First diagnostic laparoscopy was performed on 3rd day of admission and found to be normal. Because of rising serum beta-HCG second laparoscopy was performed and it was converted to a laparotomy as a caesarean scar site pregnancy was suspected. Sub-total hysterectomy was performed in order to remove suspected caesarean scar molar pregnancy. Patient recovered completely with normal beta-HCG on 20th post day. Pieces of tissue obtained from between the anterior abdominal wall and the previous caesarean section scar revealed diagnosis of complete hydatidiform mole.</span></span></span> <p style="margin-bottom: 0in;"><span style="color: #231f20;"><span style="font-family: Helvetica-Narrow-BoldOblique,sans-serif;"><span style="font-size: x-small;"><em><strong>Background: </strong></em></span></span></span><span style="color: #231f20;"><span style="font-family: Helvetica-Narrow,sans-serif;"><span style="font-size: x-small;">Implantation at the caesarian scar site can lead to first trimester miscarriages, placenta previa, placenta accreta or ectopic pregnancy. While caesarean scar site ectopic pregnancy is a rare occurrence; caesarian scar site molar pregnancy is extremely rare. We report this case to highlight the importance of high index of suspicion and proper monitoring in diagnosing this condition.</span></span></span> <p style="margin-bottom: 0in;"><span style="color: #231f20;"><span style="font-family: Helvetica-Narrow,sans-serif;"><span style="font-size: x-small;">DOI: <a href="http://dx.doi.org/10.4038/sljog.v35i2.6162">http://dx.doi.org/10.4038/sljog.v35i2.6162</a></span></span></span> <p style="margin-bottom: 0in;"><span style="color: #231f20;"><span style="font-family: Helvetica-Narrow-Bold,sans-serif;"><span style="font-size: x-small;"><em><span style="font-weight: normal;">Sri Lanka Journal of Obstetrics and Gynaecology</span></em><strong> </strong><span style="font-family: Helvetica-Narrow,sans-serif;">2013; 35: 62-64</span></span></span></span> <p style="margin-bottom: 0in;">
Highlights
Implantation at the caesarian scar site can lead to first trimester miscarriages, placenta previa, placenta accreta or ectopic pregnancy
The pieces of tissue obtained from between the anterior abdominal wall and the previous caesarian section scar revealed enlarged chorionic villi with central cisternal changes and trophoblastic proliferation, which confirmed the diagnosis of complete hydatidiform mole
Gestational trophoblastic disease is a spectrum of diseases including hydatidiform moles, invasive moles, gestational choriocarcinomas, and placental site trophoblastic tumors
Summary
A 40 year old multiparous asymptomatic woman presented at 9+ weeks with a finding of rising serum beta-HCG over 3500 IU without ultrasonically detectable intra-uterine pregnancy. First diagnostic laparoscopy was performed on 3rd day of admission and found to be normal. Because of rising serum beta-HCG second laparoscopy was performed and it was converted to a laparotomy as a caesarean scar site pregnancy was suspected. Sub-total hysterectomy was performed in order to remove suspected caesarean scar molar pregnancy. Patient recovered completely with normal beta-HCG on 20th post day. Pieces of tissue obtained from between the anterior abdominal wall and the previous caesarean section scar revealed diagnosis of complete hydatidiform mole
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